Unfortunately, the night before I’d been hit with a stomach ache, possibly the result of indulging too much at a birthday celebration at a Winston-Salem restaurant. I’d let the staff at the Comprehensive Cancer Center know about the stomach ache when I arrived. My oncologist proceeded with the CAT scan, but she decided not to go ahead with any chemotherapy. Even though the pain had vanished at the time of the CAT scan, I was told to go home, but first she gave me the results of the CAT scan.
Lymph Node Shrinks
The lymph node was down in size by a third. ICE had been successful for me, but it wasn’t successful enough. Two-thirds of the little thing still remained. My oncologist let me know that when chemotherapy resumed she wanted to use an even stronger formulation, in fact, the strongest formulation currently available for lymphoma. And what about the stomach ache? Might the CAT scan reveal what had caused it?
It did. Anyway it gave large clues as to what might have caused it. The CAT scan revealed that the probable cause of the pain I had experienced the night before was a gallbladder flare up. I was to go home for a week and see if the gallbladder behaved itself or if the problems from it, not just pain, but also nausea or fever showed themselves. If I had any of these three, I was to come back to the hospital immediately and be admitted right away.
Gallbladder Diet
Harriet and I decided to keep the gallbladder in check with diet—a diet of substantially reduced saturated fats and also a diet rich in vegetables such as beets, celery, cucumbers, green beans and other items we found listed on very helpful websites. The gallbladder caused no trouble, and I was able to come back to the hospital pain, nausea and fever free at the newly scheduled time—that is, starting on April 17.
The session on April 17 started with an echo cardiogram to make sure my heart could take the new stronger regimen. Immediately after that, I had an ultrasound of the area of the abdomen where the gallbladder resides. A blood test came next, and then I met with Denise Levitan, my oncologist. Finally I was admitted for what would be my longest stay yet at WFU Baptist, six days of intensive chemotherapy.
Hello R-EPOCH
And what is this strongest formulation yet? It’s my old “friend” CHOP from 2002 or rather R-CHOP—“R” for Rituxan—with modifications to make it even more intensive. This latest version is known as EPOCH, but it might well be called R-EPOCH. Rituxan is still part of the mix as is Etoposide from ICE. From CHOP comes the wonderful sounding mix of Doxorubicin (also known as Adriamycin), Vincristine Sulfate (also known as Oncovin), and Cyclophosphamide (also known as Cytoxan).
Taken orally, rather than through transfusion, is the final and very important part of the group, the steroid Prednisone. It is the job of Prednisone to build you back up from the beating that the infused chemicals mete out on the body. I’m repeating myself from past postings, but remember that the chemicals of chemotherapy have the job of killing cancer rather than building up what might already be strong and healthy in the body. One problem is that they kill much more than that which needs killing.
Called An Ordeal
How did it go? These consecutive days of chemotherapy at the hospital—six in this case--can only be described as an ordeal. They are tough, and it would be inaccurate of me to gloss over them and make them sound more pleasant than they are. On the other hand, I do have to state that I have been consistently impressed with the staff of WFU Baptist. These are highly trained, dedicated and compassionate people. No blame is due to the perpetrators and administrators.
During my six days in the hospital as in my previous stays, I never felt neglected or ignored. At those rare times when the nurse and aid assigned to me were not available to answer my call, there was always a back-up person to come running. And, I have to add, the Baptist staff strikes me as committed to the concept of total care. These are warm people who constantly show concern for their patients, not bureaucrats constrained to business-like interactions.
Family Sleep-Overs Accepted
Baptist is also quite accepting about allowing a family member to stay overnight with the patient in the patient’s room. This is the situation with its cancer patients, in any case.
In the category of “ordeal” are several items. First having to get stuck so much for the drawing of blood and the establishing of IV’s. During my recent stay I underwent minor surgery to reduce the number of times I’ll have to get stuck in the future, that is, the installation of what is called a portocath or portable catheter in my chest. In addition to reducing the number of sticks, the portocath provides a central line hooked to a main artery of the body to minimize the danger of artery damage. The infusion of strong chemo like R-EPOCH can blow out small veins such as those in the arms.
Tied to Infusion Tree
Then there is the annoyance of being hooked up to an infusion tree. Everywhere you go—to the bathroom, for a walk in the halls—the tree with its very sophisticated electronic pumps goes with you. It is your constant companion. Fortunately, there are wheels at the bottom of the tree, but the thing is often unwieldy and you have to be very careful not to trip over it.
Another part of the ordeal is simply being in the hospital. That probably sounds like a contradiction after what I said about how good the staff at Baptist is. The good and the bad intertwined—that is so often the nature of life, right? When you are in the hospital, you are constrained. You are confined. You are forced to adhere to other people’s schedules and to do what other people think you ought to do when they think you ought to do it.
Prefer Writing, Walks
Frankly, I’d rather be sitting in front of my computer and composing a poem or a blog posting. I’d rather be listening to the birds sing as I walk with our Portuguese Water Dog Cassie Rose by a beautiful mountain stream and vicariously experience with her the pleasure she gets out of being able to dash in and out of the water at will.
Then there are all the changes that chemotherapy does to the body, which I’ve written about before—the hair loss, the nausea, the appetite changes, the fatigue, the occasional feelings of ineptness and stupidity. Not great.
What happens next? In about two weeks I’m back to Baptist for more R-EPOCH. I’ll have another CAT Scan, and then we’ll see. If I’m finally in remission, it’s full speed ahead to the bone marrow transplant. Anyway I hope that is what is in store for me. I’m anxious to get this episode in my life over and done with.
To see a sampling of the writings of this author, see the website at http://www.sasaftwrites.com.
Copyright © 2008 by Stephen Alan Saft
